KẾT QUẢ VÀ TÍNH AN TOÀN CỦA CẮT HỚT NIÊM MẠC DƯỚI NƯỚC SO VỚI CẮT QUY ƯỚC TRONG ĐIỀU TRỊ POLYP ĐẠI TRỰC TRÀNG KHÔNG CUỐNG KÍCH THƯỚC TỪ 10 - 30mm

Abstract

Objectives: To compare the efficacy and safety of underwater endoscopic mucosal resection (UEMR) with conventional endoscopic mucosal resection (CEMR) in the treatment of 10 - 30mm nonpedunculated colorectal polyps. Methods: A randomized, controlled, clinical interventional, open-label study was conducted at Military Hospital 103 between July 2024 and December 2025 and included 178 patients with nonpedunculated colorectal polyps measuring 10 - 30mm, treated with either UEMR or CEMR. Clinical, endoscopic, and procedural outcomes, as well as complications, were compared between the two groups. Results: The en bloc resection rate was high in both groups, with no statistically significant difference between UEMR and CEMR (96.6% vs 92.1%; p > 0.05). In the subgroup of polyps measuring 20 - 30mm, UEMR achieved a significantly higher en-bloc resection rate (91.3% vs 62.5%; p = 0.028). The UEMR group had a shorter procedure time and a lower rate of hemostatic clip use compared to the CEMR group (p < 0.05). The overall complication rates were low and comparable between the two techniques. Conclusion: Both UEMR and CEMR are safe and effective methods for the treatment of 10­ - 30mm nonpedunculated colorectal polyps. UEMR shows a trend toward improved en bloc resection rates, particularly in lesions measuring 20 - 30mm, as well as shorter procedure time and reduced need for hemostatic clips, while maintaining a comparable safety profile.